Opportunistic screening for diabetes and hypertension in the outpatient clinics in Sierra Leone : A pilot study

Objective: This study sought to determine the feasibility of screening for diabetes and hypertension among patients visiting outpatient clinics in urban and rural Sierra Leone. Background: Developing African countries are faced with a rising epidemic of non-communicable diseases such as diabetes, and hypertension. Most people only seek episodic medical care, so their chronic diseases remain undiagnosed until they present with associated complications. Study Design and Methods: Forty-nine adult patients seeking medical care for acute illnesses in 2 outpatient clinics- one rural and one urban, were recruited for the study. Blood pressure, fasting blood glucose, and BMI screenings were done. Information on risk factors was also obtained. Results: The mean blood glucose was 101 mg/dL. Two patients (4.2%) had diabetic range blood glucose levels. Twenty-four patients (51%) had impaired fasting glucose using the ADA criteria with 34% from the urban and 17% from the rural clinic. Five patients (10.7%) had impaired fasting glucose using the WHO criteria; 4.3% from the urban and 6.4% from the rural clinic. The mean blood pressure was 136/85. Fifty percent of patients had hypertension, and 36.4% were in the pre-hypertension range. The mean BMI was 26.5 kg/m2. All obese patients were from the urban clinic. Conclusions: Obesity and undiagnosed hypertension prevalence rates in the clinics were higher than national prevalence estimates whereas undiagnosed diabetes rates were similar to estimated national prevalence rates. This pilot study demonstrates that screening in outpatient clinics could be a feasible and cost-effective method for early detection of diabetes, and hypertension.